Burning Research Articles

Design and Evaluation of Microemulsion-Based Drug Delivery Systems for Biofilm-Based Infection in Burns

Normal skin is the first line of defense in the human body. A burn injury makes the skin susceptible to bacterial infection, thereby delaying wound healing and ultimately leading to sepsis. The chances of biofilm formation are high in burn wounds due to the presence of avascular necrotic tissue. The most common pathogen to cause burn infection and biofilm is Pseudomonas aeruginosa. The purpose of this study was to create a microemulsion (ME) formulation for topical application to treat bacterial burn infection. In the present study, tea tree oil was used as the oil phase, Tween 80 and transcutol were used as surfactants, and water served as the aqueous phase. Pseudo ternary phase diagrams were used to determine the design space. The ranges of components as suggested by the design were chosen, optimization of the microemulsion was performed, and in vitro drug release was assessed. Based on the characterization studies performed, it was found that the microemulsion were formulated properly, and the particle size obtained was within the desired microemulsion range of 10 to 300 nm. The I release study showed that the microemulsion followed an immediate release profile. The formulation was further tested based on its ability to inhibit biofilm formation and bacterial growth. The prepared microemulsion was capable of inhibiting biofilm formation.Graphical

Healing Potential of the Marine Polysaccharides Carrageenan and Ulvan on Second-Degree Burns.

The treatment of second-degree burn wounds presents a significant clinical challenge, often characterized by prolonged healing times and risk of complications. In this study, the wound healing potential of bioactive marine sulfated polysaccharides ulvan and carrageenan formulated in gels at concentrations of 1.5%, 5.0%, and 10% w/w was evaluated. Hairless female SKH-hr2 mice (n = 7 per treatment) with burn-inflamed skin were treated with the polysaccharide-based gels, and the therapeutic efficacy was assessed using a comprehensive array of evaluation methods, including a histopathological analysis, clinical observation, photo-documentation, an image analysis, an evaluation of biophysical skin parameters, and FT-IR spectroscopy. Our findings indicate that the 10% w/w carrageenan gel exhibited significant enhancement in wound healing, particularly in the early stages of the healing process. This was evidenced by the restoration of the α-helix structure of collagen and the configuration of glycosaminoglycans, as demonstrated by FT-IR absorption bands of the skin both in vivo and ex vivo. Furthermore, the 5% w/w ulvan gel also demonstrated notable efficacy in promoting wound healing, particularly in the later stages of the healing process. These results suggest that carrageenan and ulvan gels hold promise for improving the efficiency of wound healing in second-degree burn wounds. Our study contributes to the understanding of the therapeutic potential of marine polysaccharides and provides insights into their mechanism of action in promoting wound healing.

Hyperbaric Oxygen Therapy for Burn Injuries: A Case Study and Review

Hyperbaric Oxygen Therapy for Burn Injuries: A Case Study and Review

Bacteriophage therapy reduces Staphylococcus aureus in a porcine and human ex vivo burn wound infection model.

Burn wounds are a major burden, with high mortality rates due to infections. Staphylococcus aureus is a major causative agent of burn wound infections, which can be difficult to treat because of antibiotic resistance and biofilm formation. An alternative to antibiotics is the use of bacteriophages, viruses that infect and kill bacteria. We investigated the efficacy of bacteriophage therapy for burn wound infections, in both a porcine and a newly developed human ex vivo skin model. In both models, the efficacy of a reference antibiotic treatment (fusidic acid) and bacteriophage treatment was determined for a single treatment, successive treatment, and prophylaxis. Both models showed a reduction in bacterial load after a single bacteriophage treatment. Increasing the frequency of bacteriophage treatments increased bacteriophage efficacy in the human ex vivo skin model, but not in the porcine model. In both models, prophylaxis with bacteriophages increased treatment efficacy. In all cases, bacteriophage treatment outperformed fusidic acid treatment. Both models allowed investigation of bacteriophage-bacteria dynamics in burn wounds. Overall, bacteriophage treatment outperformed antibiotic control underlining the potential of bacteriophage therapy for the treatment of burn wound infections, especially when used prophylactically.

“Diya”-Related Burn Injuries during the Diwali Period: A 5-Year Retrospective Review from a Tertiary Care Hospital in India

Abstract Background Diwali is a festival that is passionately celebrated by Indians all across the globe. Fire hazards associated with this festival are well known. Our hospital is a tertiary care burn center and caters to a patient population from all over North India. Firecracker burns and diya burns constitute two major causes of burn injuries during the festival of Diwali. Since, diya-related burn injuries have been overlooked in the past, this study was primarily designed to study the demographical data of “diya burns” during Diwali. Materials and Methods The departmental records were analyzed for 3 days around Diwali festival over a period of 5 years from 2018 to 2022. Results The results indicated that almost a third of all Diwali-related burns were caused by diyas (32.5%). A “burning diya left on floor” was the main reason for these injuries. Females were the most affected (70.4%). Additionally, one-third of these patients required admission. Conclusion This study emphasizes the need for raising awareness regarding the proper use of “diyas” to bring down the incidence of such preventable burn injuries.

Higher energy delivery is associated with improved long-term survival among adults with major burn injury: A multicenter, multinational, observational study.

Numerous feeding strategies have been used to mitigate the catabolism of major burn injury. Whether higher energy and/or protein delivery results in better long-term outcomes is unknown. We performed a secondary analysis of data from adults with major burn injuries enrolled in the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury at 54 burn centers in 18 countries. The sample was restricted to those who were mechanically ventilated within 72 hours of injury and for ≥7 days. Our key exposure was adequacy of energy, and protein ([Deliveredi/Prescribedi] × 100) was categorized into three groups each: low, 0% to 50%; moderate, ≥50% to 79%; and high, ≥80%. We also analyzed adequacy using restricted cubic splines. Primary and secondary outcomes included 6-month mortality and functional outcomes (i.e., 36-Item Short-Form Health Survey, Katz Index of Independence in Activities of Daily Living, Lawton Activities of Daily Living scores), respectively. Regression models were adjusted for age, body mass index, Charlson Comorbidity Index, baseline Acute Physiology and Chronic Health Evaluation II and modified Sequential Organ Failure Assessment scores, burn size, energy/protein adequacy, and study site. A total of 493 participants met the cohort restriction criteria; 336 participants were alive at 6 months. 36-Item Short-Form Health Survey, Katz Index of Independence in Activities of Daily Living, and Lawton Instrumental Activities of Daily Living Scale were completed by 218, 216, and 215 participants, respectively. The mean ± SD age was 48 ± 17 years, and 74% were male. The mean ± SD burn size was 41% ± 18% total body surface area. Participants who received 25% of recommended calories had nearly four times the hazard of death during the 6-month follow-up period than participants who received 100% of prescribed calories (adjusted hazard ratio, 3.89; 95% confidence interval, 1.35-11.20) (p = 0.02). There was no significant association between protein and 6-month mortality or energy/protein delivery and 6-month functional outcomes. There was a positive association between higher doses of energy and 6-month survival. This relationship conflicts somewhat with several energy studies among critically ill and non-burn-injured patients. The lack of consistent evidence on optimal nutrition for critically injured patients, a fundamental component of burn care, suggests potential for a randomized trial of lower versus higher energy to improve long-term outcomes after burn injury. Therapeutic/Care Management; Level III.

Dermatological rehabilitation in burned children: an integrative review

Introduction: Dermatological rehabilitation in burned children plays a crucial role in restoring skin function and aesthetics after burn injuries. This integrative literature review aims to comprehend the methods and outcomes related to this practice, exploring relevant studies in the field. Methods: To conduct this integrative review, we utilized the PubMed, Scielo, and Virtual Health Library databases. We used specific keywords such as "dermatological rehabilitation," "burned children," and "pediatric burns" to locate relevant articles. Article selection was based on relevance and research quality criteria. Results: This integrative review encompassed various studies related to dermatological rehabilitation in burned children. Some studies focused on negative pressure therapy and its role in the recovery of electric burn injuries. Others explored the use of dermal regeneration matrix in burned patients. Additionally, epidemiological studies were included, providing insights into the profile of burned children treated in hospitals. The review also addressed the importance of physiotherapy in burned patient rehabilitation and factors associated with physical sequelae in burned children. Strategies of kinesiotherapy and the dermatologist's approach in the initial burn care were also discussed. Conclusion: Dermatological rehabilitation in burned children is a multidisciplinary field that requires diverse and individualized approaches. The integrative review highlighted the significance of innovative techniques and treatment strategies to enhance outcomes and the quality of life for burned children. The knowledge gained from these studies can contribute to the improvement of dermatological rehabilitation practices in burned children in the future.

Acceptability and Usability of Smileyscope Virtual Reality for Paediatric Pain Management During Burn Procedures: Perspectives of Patients, Carers and Clinicians.

To explore clinician, child and parent acceptability and usability of the Smileyscope VR device in the context of addressing the unique pain and distress needs of young burn patients. A survey comprising closed and open-ended questions. Descriptive statistics analysed participant characteristics, pain and analgesia. Qualitative content was collected from April 2022-August 2022 and analysed to identify barriers and enablers. Categories were then mapped onto the Capabilities, Opportunities and Motivation-Behaviour Wheel (COM-B) framework. Smileyscope was found to be effective for reducing pain and anxiety during dressing changes by both patients (n = 39) and parents (n = 37). Clinicians (n = 35) reported high self-efficacy and willingness to reuse the device. However, concerns arose regarding the device's fit and the need for age-appropriate programmes. Smileyscope demonstrated promise in reducing procedural pain and distress. The device is well accepted by all participants implying ease of implementation. Feedback suggests further program development and fitting optimisation is required. Improved procedural pain has proven to decrease wound healing times, decreasing possible need for further scar management and long-term consequences after sustaining a burn injury. Smileyscope use in rural hospitals presents valuable opportunities for optimising early paediatric burn pain. Increased burn pain can delay wound healing and have long term physical and psychological impact on patients. Smileyscope was well received within this cohort; however, improvements in device design and programmes were suggested. This study shows the potential for use of Smileyscope as a non-pharmacological approach to improving paediatric burn pain and distress. While our study included patients, parents and clinicians as research participants, there was no patient or public contribution in the design or conduct of the study, analysis or interpretation of the data.

High-Voltage Electrical Burn Requiring Urgent Scalp Reconstruction after Developing a Brain Abscess

Electrical burn injuries to the scalp are at risk of extensive tissue damage and neurological complications. We present the case of a patient who came into contact with a high-voltage power line while cherry picking, resulting in a large full-thickness scalp defect. Early on in his presentation, he developed progressive global weakness which remained relatively static during his admission. An incidental finding of an extradural abscess complicated his management, requiring urgent surgical intervention with definitive tissue coverage. The scalp was reconstructed using a free myocutaneous anterolateral thigh flap. There were no postoperative complications. Following rehabilitation, the patient was discharged home with limited functional recovery. He mobilises independently with a wheelchair and requires full-time carers.

Awareness of Burn Injury Prevention and First Aid Management Among Adults in Jazan, Saudi Arabia.

Burn injuries represent a significant public health concern, with the effectiveness of preventive measures and first aid largely dependent on public knowledge. This study aimed to evaluate the awareness of burn injury prevention and first aid management among adults in Jazan, Saudi Arabia. A cross-sectional survey was administered to adults in Jazan using a structured questionnaire. The survey assessed participants' knowledge of burn causes, preventive strategies, and first aid practices. Responses were analyzed to gauge the level of awareness and identify gaps in knowledge. Among the participants (n = 400), 71.3% (n = 285) recognized hot liquids as a primary burn hazard, 27.4% (n = 109) identified electricity, 97.0% (n = 388) cited fire, and 53.8% (n = 215) acknowledged chemicals. In terms of preventive measures, 61.6% (n = 246) understood the importance of following manufacturer safety guidelines, 78.8% (n = 315) knew to keep chemicals out of children's reach, 72.4% (n = 289) were aware of the need to wear gloves, and 61.6% (n = 246) recognized the necessity of avoiding the storage of unnecessary chemicals. For first aid practices, 91.8% (n = 367) knew to use water, 50.8% (n = 203) would seek medical attention, 22.6% (n = 90) would cover burns, and 20.3% (n = 81) considered pain management important. The findings indicate a strong awareness among adults in Jazan regarding burn injury causes, prevention, and first aid practices. Despite this, gaps remain in specific first-aid responses and comprehensive safety measures. Targeted educational initiatives could address these gaps and enhance burn injury prevention and management.

Prospects for the application of cell therapy in combustiology

Currently, one of the urgent problems in the field of surgery and traumatology is burn injury. A significant part of the victims has deep and extensive burns, the treatment of which is the most difficult problem of modern combustiology. In this aspect, one of the main problems faced by surgeons in combustiology is the lack of donor material and an increased risk of complications of burn wounds. In this regard, the most promising direction in kombustiology is the application of cell engineering methods, including the use of fibroblasts and stem cells. Fibroblasts have a number of advantages, such as efficiency, safety and accessibility. Stem cells are also a common method of cell therapy, they have great potential in regenerative processes. Mesenchymal stem cells (MSCs), which have a pronounced regenerative and immunosuppressive effect, are also used in kombustiology. In the treatment of infected burn wounds, phage therapy, which provides lysis of infectious pathogens, showed a positive result. In addition to fighting pathogens, bacteriophages, like MSCs, have an immunosuppressive effect, thereby reducing the risk of transplant rejection.

Determination of the Use of Complementary and Alternative Treatment Methods in Burn Wounds of Patients Who Apply to The Emergency Department with Burn Complaints

Objective: The study was conducted to determine the use of complementary and alternative treatment methods in burn wounds of patients who applied to the emergency department with burn complaints. Material-Method: This descriptive and cross-sectional study was conducted with 100 patients who applied to the emergency department with burn complaints. A questionnaire containing the socio-demographic information of the patients, a questionnaire containing the characteristics of the burn, and a questionnaire determining the knowledge and use of complementary treatment methods used in burns were used to collect the data. Results: It was determined that 32% of the participants were burned due to scalding, and the burns that occurred were generally 1st and 2nd degree-burns. Participants stated that they knew that the traditional methods used in burn treatment were washing with cold water (43.9%), St. John's wort oil (17%) and yoghurt (14.6%). It was determined that the methods they used in burn treatment were cold water (90.8%) and St. John's wort oil (5.7%). Conclusion: In line with the data obtained from the study, it was determined that the participants knew many complementary and alternative treatments for burn injuries but did not use these methods.

Recent trends in antibiotic sensitivity and resistance patterns in infected wounds of burns patients presented to a tertiary care hospital.

Objective: To study the recent trends and patterns of antibiotic sensitivity and resistance in infected wounds of burns patient. Study Design: Cross sectional study. Setting: Burns and Plastic Surgery Canter, Peshawar, Pakistan. Period: July 30th to January 30th, 2023. Methods: In this cross sectional study we adopted convenience sampling technique. A total of 75 samples collected from patients fitted to our infected patients criteria and culture and sensitivity tests were performed using standard microbiological techniques. Results: Among the positive infected wound samples, Klebsiella Species were found in 23 (30.7%), Pseudomonas Aeruginosa in 16 (21.3%), Acinetobacter Species in 14(18.7%), Proteus Species in 8(10.7%), Citrobacter species in 5(6.6%), Staph. Aureus in 5(6.6%), Enterobacter species in 3(4%) and E.coli in 1(1.4%) of the positive cultures. Each pathogen showed varying degree of sensitivity and resistance patterns to different antibiotics tested. Conclusion: Klebsiella Species was the most common pathogen in patients with infected burns wounds. Meropenem, imipenem, Doripenem, Piperacillin/Tazobactum, Colistin, and Tigecyclin were found to be effective against the majority of the bacteria. Conversely, most of the bacterial strains exhibited resistance to commonly prescribed antibiotics such as co-amoxiclave, ampicillin, ceftriaxone, ciprofloxacin, cefotaxime and co-trimoxazole.

Design And Characterization Of Regenerative Potential In Full Thickness Burn Wound Model

Hydrogel is a three-dimensional network of interconnecting polymers that is crosslinked and consists of hydrophilic polymers that can absorb and endure water. Because it mimics the extracellular matrix (ECM), the hydrogel has found widespread use in pharmacological and biological applications. Many types of wound dressings are based on hydrogels due to its many advantages. These dressings include Coseal, Tegaderm, Algisite, and Evicel. Notwithstanding their exceptional ability to cure wounds, they have many drawbacks, including expensive expenses, unfavourable storage conditions, and inadequate mechanical protection for the wound. As we have come to realise the need for dressings with greater performance qualities (e.g., antimicrobial, biodegradable, responsive, and injectable), the field of wound dressings has attracted an increasing amount of interest. The purpose of this work is to evaluate the hydrogel loaded with 7, 8-Dihydroxy flavone's healing capabilities in a full-thickness burn wound model.

Has the energy poverty crisis fuelled a rise in hot water bottle burn injuries within the United Kingdom?

IntroductionThere are an estimated 10 million hot water bottles (HWB) currently in use within the United Kingdom (UK), and HWB related burn injuries represent a significant resource burden to UK Burns Services. These injuries can be caused through a variety of mechanisms including scalds sustained when filling the bottle or scalds from leaking or rupture. The fuel poverty crisis started in February 2022 leading to an estimated six-fold increase in alternative sources of heating, in particular hot water bottles. In this study, we wish to understand the impact that this may have had upon burn injuries sustained by these products. MethodsAll hot water bottle (HWB)-related injuries sustained January 2014 - February 2023 were retrieved from the UK International Burn Injury Database (IBID). Data were collected on patient demographics, injury mechanism, anatomical location, and clinical outcomes. The data were collated and analysed; statistical analysis was performed using R StudioTM. Patient levelling costs were also incorporated to enable translation of these data into healthcare costs. ResultsA total of 5944 HWB-related burn injuries were recorded in the IBID database in England and Wales, from 2014 to 2023, with a mean of 594 (SD 146.2) burn injuries annually, costing an estimated £ 12.7 million. There were 423 burn injuries sustained from HWB in winter 2022 compared to 295 in winter 2021, representing a 43.4 % increase over one year, with a corresponding increase of 43.1 % in the number of patients managed in an outpatient setting. The largest increase in burn incidence between winter 2021 and winter 2022 was seen in children (0–16 years old) and older adults (greater than 65 years old) with a rise of 60.3 % (n = 41) and 68.5 % (n = 37) respectively. ConclusionOur epidemiological study on hot water bottle (HWB)-related burn injuries within the United Kingdom has shown that the dramatic rise in fuel prices, which sparked the fuel poverty crises, has coincided with a 43.4 % increase in HWB burns incidence on the health service in that year alone. This alarming rise in HWB-related injuries highlights the continued need for targeted public awareness campaigns to ensure a safe and proper use of these devices.

The effect of acellular scaffold loaded with Wharton's jelly-derived stem cells and mineral pitch on healing of burn model in rat.

Severe burns often result in an exacerbated inflammatory response, which can contribute to further injury. This inflammatory response may lead to an increased risk of infection, multiple organ failure, and death. This study aimed to investigate the potential of reducing inflammation to enhance burn wound healing in rats using ovine's small intestinal submucosa as a carrier for Wharton's jelly mesenchymal stem cells (WJ-MSCs) and Mineral Pitch (MP). A rat burn model was developed, and the animals were divided into four groups: control group: burn, placebo group: scaffold-treated burn, cell experimental group: WJ-MSCs seeded scaffold-treated burn, and cell and MP experimental group: scaffolds loaded with WJ-MSCs and MP-treated burn. After treating the wounds in the relevant groups and sampling them on days 5, 14 and 21, histological and pathological parameters, and the expression of genes involved in angiogenesis and epithelialization were evaluated. The study results revealed several findings in the burn wounds. These included changes in mast cell populations, a decrease in inflammatory neutrophils and lymphocytes, an increase in fibroblasts and blood vessels, and upregulation of angiogenesis and epithelialization genes. These changes collectively contributed to enhanced wound healing in cell and MP experimental group compared to the other groups. The findings suggest that scaffolds loaded with Wharton's jelly-derived stem cells and MP can serve as engineered tools to modulate inflammatory conditions during the burn wound healing process. These interventions can improve burn wound management and promote better outcomes.

Translational potential of test systems in modelling thermal burn wounds

The article describes the advantages and features of experimental models of thermal burns using in vitro, ex vivo and in vivo test systems. An objective assessment of the application of each approach depending on the type of study is given. For example, cell culture models are simple but do not fully reflect the structure of human skin, which limits their translational value. Ex vivo models, such as skin explants, provide the necessary architectonics to study intercellular interactions, but they also have drawbacks, primarily related to short viability. In general, in vitro and ex vivo models have limitations in reproducing all aspects of burn wound pathogenesis and healing. In this regard, laboratory animals, primarily mice, rats, and pigs, are widely used to study burn wound pathology, its effects on the body, and the efficacy of therapy. The decision to use experimental animal models is made taking into account their translational relevance to humans. In rodents, wound healing occurs mainly by contraction, in contrast to the re-epithelialisation and granulation seen in humans, which contributes to faster wound healing in rodents. The significant similarities between certain properties of pig and human skin make the latter a relevant test system in pharmacodynamic studies of thermal burn wounds.

Burn injuries in clinical practice: Principles and management for general physicians

ABSTRACT Burn injuries, although largely preventable, continue to pose a significant global health burden and substantially contribute to morbidity and mortality. This study emphasises the pivotal role of timely and effective burn care in mitigating the adverse consequences of these injuries. General physicians often serve as frontline responders to burn incidents, highlighting the importance of proficiency in burn management for accurate diagnosis, prognosis and appropriate referral to specialised burn units. Prompt initiation of acute burn care is paramount, with first-aid interventions playing a crucial role in shaping patient outcomes and reducing morbidity and it highlights the essential principles of burn care that general physicians should apply to enhance patient care outcomes. This emphasises the critical role of general physicians in implementing these principles effectively. In addition, it underscores the necessity of a multidisciplinary approach, advocating collaboration between general physicians and specialised burn care teams to ensure comprehensive patient management and rehabilitation. Ultimately, effective burn care enhances individual patient outcomes and reduces the overall burden of burn injuries on healthcare systems and society.

Spreadable thermosensitive nanocomposite hydrogel dressing with ultrasound-responsive bactericidal/repair-promoting regulation and cascade antioxidantion for infected burn wound repair

Treating severe burn wounds poses significant challenges, including considerable cell loss, excessive inflammation, and a high susceptibility to bacterial infections. Ideal burn dressings should exhibit excellent antibacterial properties, anti-inflammatory effects, and promote cell proliferation. Additionally, they need facilitate painless dressing changes and be user-friendly. Herein, we synthesized a thermosensitive hydrogel by crosslinking poly (N-isopropylacrylamide-co-allyloxybenzaldehyde) (PNA) and amino-terminated Pluronic F127 (APF) through a Schiff base reaction. It exhibited reversible gel-sol transition and spreadability. By incorporating piezoelectric gold nanoparticle-modified barium titanate (Au@BaTiO3) and cascade antioxidant MOF-818, a nanocomposite hydrogel dressing with diverse bioactive functionalities was developed. Results demonstrated that the nanocomposite hydrogel possessed gel-sol transition properties, maintained a stable gel state within a broad temperature range, and desirable self-healing property. Au@BaTiO3 exhibited good piezoelectric properties and ROS generation upon ultrasound stimulation, while MOF-818 displayed highly efficient cascade nanozyme activity. The combination of Au@BaTiO3 and MOF-818 promoted fibroblast proliferation and migration, reduced intracellular ROS levels, and induced anti-inflammatory polarization of macrophages under ultrasound stimulation. In vitro and in vivo antibacterial results disclosed that the nanocomposite hydrogel had excellent antibacterial activity under high-intensity ultrasound stimulation. When applied to infected burn wounds, the nanocomposite hydrogel can rapidly sterilize the wound upon initial high-intensity ultrasound, and then reduce inflammation and promote M2 macrophage polarization by the following low-intensity ultrasound stimulation, and thus accelerating the healing by improving granulation tissue formation, angiogenesis, and collagen deposition.

Potential therapeutic effects of topical recombinant human erythropoietin on burn wound healing: A preliminary randomized double-blind controlled clinical trial

BackgroundBurn injuries can cause significant mortality and morbidity. This study aimed to evaluate the efficiency of topical recombinant human erythropoietin (rhEPO) on enhancing burn wound healing. MethodsIn this randomized double-blind controlled clinical trial, we enrolled 40 participants aged 18 years and older who were referred to a burn center during the first 24 h of burning. The participants with no concurrent comorbidities had superficial and deep second-degree burns, no respiratory burns, no face and perineum burns, no keloid formation, or a healed, fully epithelialized, hypertrophic burn scar. Topical rhEPO or nitrofurazone/Vitamin A was administered every other day, and the patients were scheduled for follow-up visits to receive wound cleansing, debridement, and dressing changes. Burn wound healing response to treatment was measured as the study main outcome. ResultsAt the second follow-up visit, all parameters were significantly lower in the rhEPO group compared with the control group except for itchiness. The results of the next two follow-up sessions were also the same. The total value of the modified Vancouver Scar Scale (VSS) at days 5, 7, and 14 was significantly lower in the rhEPO group compared with the routine of care group.Trial Registry Date: 2022–03-02, Trial Registry number: IRCT20190810044500N23 ConclusionsThe results of the present study suggested that topical rhEPO is a potential option in burn wounds and patient satisfaction, without causing intolerable side effects.